Left ventricular hypertrophy, dilatation and ejection fractions predict ventricular tachycardia in amyloid transthyretin cardiomyopathy

Abstract Funding Acknowledgements Type of funding sources: Private company. Main source(s): Pfizer Global Medical Grant Background Amyloid transthyretin cardiomyopathy (ATTR-CM) is a progressive infiltrative caused by extracellular deposition amyloid fibrils. The disease characterized congestive heart failure, conduction abnormalities and arrhythmias. Due to the limited overall prognosis, ICDs were rarely indicated in ATTR-CM. However, with development new targeted therapies, role ICD therapy for ATTR-CM should be reevaluated. Hence, there an urgent unmet need identify patients at high risk ventricular tachycardias who might possibly benefit from therapy. Methods Between 2020 2022, 120 diagnosed tertiary referral center. Of those, 63 prospectively evaluated presence arrhythmias using 24 hours Holter-ECG. Ventricular further as sustained (sVT) non-sustained (nsVT). Results In our cohort unselected ATTR-CMP prevalence was 47.6 % (n= 30/63). majority VTs (84%) minority VT (16%). Patients showed significantly more severe left (LV) hypertrophy, reduced LV ejection fraction (LV-EF) larger atrial volumes well trend towards smaller cavities (table 1). Interestingly, no significant differences coronary artery or cardiac markers such NTproBNP troponin seen between without Furthermore, we multivariable predictive performance discriminating two backward variable selection procedures (model 1 p-value based model 2 Akaike information criterion (AIC) based). first model, LVEF (OR = 0.865 [0.776;0.963], p=0.008), LVEED (0.837 [0.708;0.991], p=0.039), mass indexed BSA (1.028[1.003;1.055], p=0.031) remained independent predictors occurrence arrhythmias, while second sodium concentration (1.287 [0.929;1.783], p=0.129) betablocker medication (5.078, [0.819;31.477], p=0.081) also retained. Comparing area under Receiver Operating-Characteristic (AUROC) observed difference both models (AUROC: 0.846 [0.711;0.937] vs. 0.870 [0.737;0.951], p=0.57, figure Conclusion tachycardia high. show advanced stage disease, LVEDD, LV-EF being models. Further studies validating value those variables are needed, including assessment nsVT sVT predicting sudden death, allowing use score